Dear colleague,

The researches on which I want to draw your attention start in 1976 at L. Sacco Hospital (Milan), where it was observed, for the first time, that Rifamycin injected by intra-articular route, developed significant therapeutic activity against arthritides, to recently land to the clinical observation that some ultrafiltrates of autologous PBMCs lysates and acellular rheumatoid synovial fluid, subcutaneously administered, are effective in treating rheumatoid arthritis. The thread that links the two treatment approaches is the presence of an autologous unknown protective peptide (m.w.≤ 10 kD) that can be released from PBMCs, through the cytolytic action of Rifamycin (or by freezing/thawing of cells) while in synovial fluid the soluble peptide would be in a free state. The researches performed in the last 10 years here under are summarized.

It is enough comprehensible that the pharmaceutical industries have a lot of perplexities to take in consideration and to invest great resources in the very complicated project aimed at identifying an autologous substance which develops its therapeutic activity when is subcutaneously reintroduced into rheumatoid patient. Our clinical results however support the notion that immunotherapy for rheumatoid arthritis by vaccination for T cell responsiveness to a cryptic self peptide or epitope is a real possibility.

If the active peptide is almost impossible to be identified for now, the clinical experiment is extremely simple however to be done: all it takes is administering subcutaneously small quantities of acellular rheumatoid synovial fluid (ultrafiltrated), drawn out from a knee with effusion persisting for at least one month.

It is not necessary to answer to this letter of mine. If you desire to have some explanation instead or want to make some clinical test don't hesitate to contact me.

The mononuclear cell responses in RA patients who have been treated with subcutaneous administration of therapeutic vaccines (see table) have not been performed yet. A total of 361 vials (the cells at -135 C° and the ultrafiltrates at -80 C°) belonging to 33 patients are stored.

This material can be used in collaboration with whom, having know-how and some resource, wanted to complete the research on the biofarmacological and immunological effects of these vaccines.

Kindest regards.

Innocenzo Caruso, email corresponding author
Past-chief of rheumatology unit of L. Sacco hospital, Milan, Italy
Honorary president of AICA